The global health care sector is under increasing strain. 

Decades of chronic underinvestment and constraints in recruitment have coincided with a surge in demand for services for aging populations. Gaps in provision are already taking a toll, with fragmented access to care and high rates of stress and burnout among staff. And it’s getting worse. The World Health Organization has warned that current shortfalls will increase to 11 million workers by 2030. 

In their urgent hunt for a solution, many health-care providers are now pinning their hopes on agentic AI, with more than two-thirds (68%) having already adopted AI agents into their workforce, according to KPMG. 

The technology is being deployed to automate complex back-office processes, collaborate with medical teams, and even triage patients, all in a bid to reduce the cognitive load on clinicians and improve quality of care for patients as the supply of human health-care workers dwindles.

A different type of digitalization 

Until now, the benefits of digitalization within health care have been limited. 

Many staff have blamed slow or outdated technology for adding to the administrative burden rather than alleviating it. For example, U.S. patient data was migrated to electronic health records (EHRs) in the early 2000s, but this data remains fragmented and reliant on manual inputs. 

New telehealth services and digital care tools, like remote monitors, have had similar shortcomings, says Ashis Barad, MD, chief digital and technology officer at Hospital for Special Surgery (HSS), an academic medical center in New York that focuses on musculoskeletal health. Both technologies have helped improve access to health care by removing geographical barriers, he says, but they’ve failed to replicate the quality of in-person care or win trust from patients. 

Agentic AI is different from these existing technologies, he insists. 

Rather than relying on manual inputs or defaulting to human workers for any case that sits slightly outside a rigid framework, AI agents can handle nuanced, complex scenarios. They can make autonomous decisions, retrieve information from expert clinical sources, and iterate over time, freeing clinicians to focus on higher-level patient care. As Dr. Barad puts it: “Agentic AI takes your workflow and collapses it, augments it, supercharges it, and makes it more performant.” 

At HSS, AI agents have already been deployed in multiple areas. They handle complex backend processes, such as insurance claims that previously took several weeks to complete and involved both HSS staff and a third-party contractor to handle the volume. Now, says Dr. Barad, AI agents complete 1,100 claims per month. They’ve reduced the appeals stage from 45 minutes to five and improved the success rate of those appeals from 65% to 100% in the nine months since implementation. HSS now handles all claims in-house. 

Building on that success, HSS is now deploying AI agents in non-clinical patient-facing settings with an AI scheduling and triage service, as part of a collaboration with enterprise agentic AI developer Ema Unlimited. The service is accessible 24/7 via web, text, or phone. It uses conversational AI to ask patients clarifying questions about their condition and then books appointments with the most appropriate clinician, factoring in location, insurance coverage, and physician availability. “It completes the whole loop,” says Dr. Barad. The AI agent is trained on “all of our context, all of our rules, and all of our knowledge base,” he adds, providing patients with streamlined access to highly specialist knowledge from world-leading surgeons.

Given the high-stakes decisions delegated to AI agents, the triage service has built-in safeguards—sensitive, complex, or uncertain scenarios are escalated to human specialists. Every decision made by the AI agent is auditable and human staff can step in at any point. Patient data is kept secure and the system is trained on all HSS protocols, policies, and care pathways. By keeping humans in the loop, Ema says its technology strikes the balance between efficient automation, patient-first safety, and human-informed decision making. 

As the technology becomes more prolific, it will be incumbent on providers to ensure they have these sorts of guardrails embedded into systems, says Dr. Barad. At HSS all decisions around the technology are filtered through an AI subcommittee that Dr. Barad co-chairs alongside a senior nursing executive. AI agents that may touch on patient care will be scrutinized with far more rigor than, say, backend processes, he explains.

AI agents prompt systems-level change

For example, Dr. Barad has plans to create a dedicated AI lab at the HSS main campus in New York City—a move that aims to democratize access to the technology across the organization. It will be open to all staff looking to understand or build AI agents, he explains, with informative classes and one-on-one training. “We’re getting agentic AI into everybody’s hands,” he says. This echoes research by Deloitte, which found that leading agentic AI adopters in health care were far more likely to have opted for multiagent solutions, redesigning end-to-end workflows rather than sticking to narrow solutions or individual use cases.

The key, it appears, is to integrate AI agents across the entire enterprise, treating them as a general-purpose technology. As Dr. Barad puts it: “It’s wrong to think of agentic AI in use cases… It’s a general-purpose technology, analogous to electricity.”

In practice, this means health-care providers need to set the right foundation to achieve value with agentic AI. This includes creating a unified data strategy, one that integrates fragmented data sources across an organization to create a single, comprehensive source of truth. In health care, data is often split across multiple departments and providers, each with their own legacy IT system.

In systems that rely on fragmented data sources, metrics often lack standardized definitions too. For example, Dr. Barad says that each hospital he’s worked in has had a slightly different definition for “time to start surgery,” a metric commonly used to gauge operating room efficiency. This level of fragmentation impedes AI agents from retrieving information from different sources or applications and assimilating the tacit knowledge that differentiates them from other technologies.

By creating greater interoperability of data at HSS, patient-facing AI agents can draw from a patient’s clinical care history and existing recommendations from their clinician, combine this information with current symptoms, and decide whether a situation requires escalation before notifying the correct specialist and informing the patient. 

Building better outcomes

For Dr. Barad, the potential for AI agents to overhaul health care and alleviate the current pressures on resources, access, and patient care is huge. 

He envisions a future in which 90% of non-clinical health-care tasks could be administered by AI agents, freeing clinicians up for what he calls white-glove work, meaning the most complex, specialized, and sensitive cases.

Most health-care providers seem equally optimistic. According to research by KPMG, 84% of providers are already comfortable handing decision making about specific processes over to AI agents.

“We’re spending so much time on keyboards and computers right now that we’re actually not doing what we should be doing,” says Dr. Barad. “This is going to rehumanize health care.”

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Amid rapidly growing adoption of enterprise-level AI agents, there’s a disconnect emerging between ambition and execution. 

Although 85% of organizations say they want to be agentic within the next three years, 76% say their current operations and infrastructure can’t support that change. They cite a lack of readiness across people, processes, and workflows. 

The sticky tape problem

The challenge is that many organisations are often layering AI agents onto existing operations, rather than reimagine the operating model and how work will need to be rewired, explains Prasun Shah, global CTO for workforce consulting and chief AI officer at PwC UK Consulting. “They’re embedding AI employees into what is a human operating model,” layering on AI agents to existing workplace structures when “this is like adding sticky tapes to parts of an operating model that is breaking.”

Doing so may be preventing organizations from unlocking the full value agentic AI offers, creating circumstances where disillusionment can quickly creep in. That full value lies in agents’ capacity to execute entire workflows with limited human input. They can coordinate complex tasks, make independent decisions, adjust to changing conditions, and iterate performance. 

In early proving grounds that span customer service, HR, and sales, it’s already estimated that AI agents could accelerate business processes by as much as 30% to 50% and low-value work time by 25% to 40% when deployed at scale. But with this capability comes greater complexity and the need for an enterprise-wide change.

Growing the AI vocabulary 

Enterprise agentic AI platform Ema describes this change as agentic business transformation (ABT), a term it coined last year in partnership with HFS Research, in an attempt to plug what it sees as a gap in the existing lexicon about AI agents, and to provide enterprises with a new framework with which to think about their own adoption of the technology. 

“None of the existing vocabulary captures the full scope of the change,” explains Ema CEO and founder Surojit Chatterjee. “Digital transformation was about moving from paper to software. AI transformation was about adding artificial intelligence to existing processes. Co-pilot is about AI assisting in various human tasks. But ABT is something categorically different: It’s the integration of AI agents into the fabric of the organization.” 

For Shah, the dedicated term (ABT) “helps drive the need to redesign an organization in its entirety: its operating model, its workflows, decision rights, and performance management systems.” He emphasizes that “everything that’s needed to ensure those agents are actually active participants in value creation, rather than just point tools or productivity aids.”

According to Ema, ABT encompasses three core pillars: an organization’s technology stack, its workforce, and the metrics used for success. 

AI agents as connective tissue

The first pillar of ABT is the technology stack. “Your existing tech stack was designed for human-operated, application-centric workflows,” says Chatterjee. “It needs to be reconsidered when the actor is an AI agent operating at machine speed across multiple systems simultaneously.”

 As AI agents are integrated into an organization, enterprises will need to pivot from a set of linear processes and steps, to rewiring work in a very different way, explains Shah. That’s because the value in AI agents isn’t as another layer in an existing technology stack but as a connective tissue, he explains, moving between or across layers to coordinate a high-level task or retrieve and interpret data from multiple discrete applications. AI agents can create “a true competitive differentiation for an enterprise” by making decisions based on this capacity to contextualize, he says. “That is where the next battleground will be.”

To build this connective tissue, leaders need to adapt their technology stack to surface higher quality decisions from AI agents, prioritizing access to multiple datasets and applications simultaneously to develop tacit knowledge. “Organizations that make this architectural shift become genuinely more adaptive,” says Chatterjee. “When a new business requirement emerges, you don’t wait six months for a software vendor to build a feature. You configure an AI employee using natural language and connect it to the systems it needs. The time from business to production workflow drops from months to days.”

The workforce, redesigned

As AI agents are deployed for more use cases, enterprise leaders must consider what this means for dynamics across their workforce, the second pillar of ABT.

Workforce structures today deviate little from the hierarchical model of the early days of industrialization. To maximize efficiency and scale, processes are standardized, tasks are clearly delineated between strategic business units (SBUs), and employees progress up through an organization based on their capacity to optimize output from teams below them. But with AI agents that can execute, coordinate, and optimize tasks—often without managerial coordination—the lines of that established hierarchy become blurred.

In a workforce that blends AI agents and human employees, managers will be freed up from many execution-based tasks but take on new responsibilities associated with managing hybrid teams. Managers “will need to be able to manage issues around trust, explainability, psychological safety, and even status dynamics” to navigate new tensions that could arise in a hybrid workforce, says Shah.

The impact of agentic AI on existing workforce structures goes far beyond the management layer, too. McKinsey predicts that by 2030, three-quarters of current jobs will require redesign, upskilling, or redeployment, and organizations will need to act swiftly to amend recruitment, retention, and remuneration. 

From output to outcome

Success metrics are the third and final pillar of ABT. 

As AI agents assume greater ownership of core enterprise processes, taking on collaborative roles alongside human employees, traditional workforce metrics that focus on activity or output—such as calls handled or reports filed—no longer make sense. 

“When you add AI employees into the workforce, activity metrics become meaningless or actively misleading,” says Chatterjee. “An AI employee can handle a thousand customer interactions in the time it takes a human to handle ten. If you measure success by interactions handled, you’ll conclude the AI is working brilliantly while missing whether any of those interactions actually drove customer satisfaction, retention, or revenue.” To correct this, enterprises must develop a new set of metrics that focus on outcome rather than output. That is, metrics on the broader benefits or changes achieved, rather than individual deliverables. 

For example, when one of Ema’s large enterprise customers overhauled its own metrics, switching from tool metrics like cost per query and AI accuracy, to outcomes like the percentage of contracts reviewed without human escalation, the measured ROI from agentic AI tripled within two quarters. The changes meant “this customer stopped building point solutions in high-volume, low-complexity workflows and started deploying AI employees where the outcome value was highest,” says Chatterjee.

Integrating new metrics may also require a complete reconfiguration of reward and talent management processes, as well as accountability and ownership within organizations, points out Shah. In human-AI teams, for example, although ethical and fiduciary responsibilities will likely remain with human employees, operational accountability will become significantly more diffused to reflect the systemic role of AI agents.

This change will raise new questions that senior leadership teams will need to wrestle with, Shah adds. They’ll need to consider: Who is accountable when an AI employee makes a mistake? What happens when AI and humans disagree? What guardrails should be erected to safeguard customers? 

Laying the groundwork for systems-level change

Systems-level change is gradual. These are complex lines of inquiry that experts continue to grapple with. But in kickstarting internal dialogue about the core pillars of ABT—the workforce, the technology stack, and the metrics by which success can be gauged—leaders can lay the groundwork for an enterprise better poised to embrace AI agents at a systems level and start to close the gap between their ambition and execution. 

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.